老年新型隐球菌脑膜炎患者的抗真菌治疗分析与药学监护  

Analysis of antifungal therapy and pharmaceutical care in an elderly patient with new type cryptococcal meningitis

作　　者：廖小梅 徐永祥 LIAO Xiao-mei;XU Yong-xiong(Heping county people's hospital,Heyuan 517200,China)

机构地区：[1]和平县人民医院,广东河源517200 [2]东莞市人民医院,广东东莞523000

出　　处：《中国处方药》2021年第12期44-46,共3页Journal of China Prescription Drug

摘　　要：目的探讨临床药师参与1例老年新型隐球菌脑膜炎的抗真菌治疗过程以及药学监护点。方法临床药师通过认真查阅指南、共识及文献,分析1例老年新型隐球菌脑膜炎患者的抗真菌治疗的诊疗方案。以抗真菌治疗感染及治疗过程中出现的并发症为切入点,协助临床医师优化抗真菌药物治疗方案,积极处理不良反应的发生,监测治疗疗效及对患者家属进行用药教育。结果治疗期间患者出现肌酐升高,考虑为两性霉素B所致肾损害,通过调整两性霉素B的剂量及更换两性霉素B脂质体等抗真菌治疗方案的优化,肾功能得以恢复。通过治疗,患者的病情好转。结论临床药师将药学知识与患者的具体病情变化结合,协助医师制定最合适患者的治疗方案,不良反应监测可作为临床药师重点监护点,为患者提供药学服务,为临床服务。Objective To investigate the antifungal therapy and pharmaceutical care of a case of senile new type cryptococcal meningitis with clinical pharmacists.Methods Clinical pharmacists analyzed the treatment plan of antifungal therapy for an elderly patient with new type cryptococcal meningitis by carefully referring to guidelines,consensus and literature.To assist clinicians to optimize the antifungal therapy plan,actively deal with the occurrence of adverse reactions,monitor the therapeutic effect and conduct medication education for patients'families,with the entry point of antifungal treatment of infection and complications in the treatment process.Results Increased creatinine was observed during treatment,which was considered to be amphotericin B induced renal damage.Renal function was restored by optimizing antifungal therapy regimens,such as adjusting amphotericin B dose and replacing amphotericin B liposome.Through treatment,the patient's condition improved.Conclusion Clinical pharmacists will combine pharmaceutical knowledge with the specific changes in patients'conditions to assist physicians in formulating the most suitable treatment plan for patients.Adverse reaction monitoring can be a key monitoring point for clinical pharmacists to provide pharmaceutical care for patients and clinical services.

关 键 词：新型隐球菌脑膜炎 老年 两性霉素B 肾损害 药学监护 

分 类 号：R742.9[医药卫生—神经病学与精神病学]